Bayonne University Hospital

All Charges

Charge

Type

Setting

Price

PIMECROLIMUS 1 % CRE

Facility

$124.00

Hospital Charge Code	60629254
Hospital Revenue Code	250
Min. Negotiated Rate	$2.99
Max. Negotiated Rate	$62.00
Rate for Payer: Aetna Commercial	$47.12
Rate for Payer: Aetna Medicare Advantage	$37.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$31.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$31.62
Rate for Payer: Cigna Commercial	$62.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$37.20
Rate for Payer: Oxford Commercial	$24.80
Rate for Payer: Qualcare PPO/HMO/WC	$18.60
Rate for Payer: UnitedHealthcare Commercial	$24.80
Rate for Payer: UnitedHealthcare Community & State	$2.99
Rate for Payer: Wellpoint Medicaid Managed Care	$3.29

PIMOZIDE 2 MG TAB

Facility

$8.60

Hospital Charge Code	60628684
Hospital Revenue Code	250
Min. Negotiated Rate	$0.21
Max. Negotiated Rate	$4.30
Rate for Payer: Aetna Commercial	$3.27
Rate for Payer: Aetna Medicare Advantage	$2.58
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$2.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$2.19
Rate for Payer: Cigna Commercial	$4.30
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$2.58
Rate for Payer: Oxford Commercial	$1.72
Rate for Payer: Qualcare PPO/HMO/WC	$1.29
Rate for Payer: UnitedHealthcare Commercial	$1.72
Rate for Payer: UnitedHealthcare Community & State	$0.21
Rate for Payer: Wellpoint Medicaid Managed Care	$0.23

PIMOZIDE 2 MG TAB

Facility

$8.60

Hospital Charge Code	60628684
Hospital Revenue Code	250
Min. Negotiated Rate	$1.29
Max. Negotiated Rate	$1.29
Rate for Payer: Qualcare PPO/HMO/WC	$1.29

Facility

$900.00

Hospital Charge Code	270656337
Hospital Revenue Code	278
Min. Negotiated Rate	$21.69
Max. Negotiated Rate	$450.00
Rate for Payer: Aetna Commercial	$342.00
Rate for Payer: Aetna Medicare Advantage	$270.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$229.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$229.50
Rate for Payer: Cigna Commercial	$450.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00
Rate for Payer: UnitedHealthcare Community & State	$21.69
Rate for Payer: Wellpoint Medicaid Managed Care	$23.85

Facility

$900.00

Hospital Charge Code	270656337
Hospital Revenue Code	278
Min. Negotiated Rate	$135.00
Max. Negotiated Rate	$217.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$180.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$217.80
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$198.00
Rate for Payer: Qualcare PPO/HMO/WC	$135.00

PIN .093(D) X 9L 35361278

Facility

$210.00

Hospital Charge Code	270638404
Hospital Revenue Code	278
Min. Negotiated Rate	$31.50
Max. Negotiated Rate	$50.82
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.50

PIN .093(D) X 9L 35361278

Facility

$210.00

Hospital Charge Code	270638404
Hospital Revenue Code	278
Min. Negotiated Rate	$5.06
Max. Negotiated Rate	$105.00
Rate for Payer: Aetna Commercial	$79.80
Rate for Payer: Aetna Medicare Advantage	$63.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$53.55
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$42.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$53.55
Rate for Payer: Cigna Commercial	$105.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$50.82
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$46.20
Rate for Payer: Qualcare PPO/HMO/WC	$31.50
Rate for Payer: UnitedHealthcare Community & State	$5.06
Rate for Payer: Wellpoint Medicaid Managed Care	$5.57

PIN 12 THR 1.65 MM X 45 MM

Facility

$661.00

Service Code	HCPCS C1713
Hospital Charge Code	270688789
Hospital Revenue Code	278
Min. Negotiated Rate	$15.93
Max. Negotiated Rate	$330.50
Rate for Payer: Aetna Commercial	$251.18
Rate for Payer: Aetna Medicare Advantage	$198.30
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$168.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$168.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$168.56
Rate for Payer: Cigna Commercial	$330.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.42
Rate for Payer: Qualcare PPO/HMO/WC	$99.15
Rate for Payer: UnitedHealthcare Community & State	$15.93
Rate for Payer: Wellpoint Medicaid Managed Care	$17.52

PIN 12 THR 1.65 MM X 45 MM

Facility

$661.00

Service Code	HCPCS C1713
Hospital Charge Code	270688789
Hospital Revenue Code	278
Min. Negotiated Rate	$99.15
Max. Negotiated Rate	$159.96
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$132.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$159.96
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$145.42
Rate for Payer: Qualcare PPO/HMO/WC	$99.15

PIN 14MM CASPAR DISTRACTOR

Facility

$4,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270657251
Hospital Revenue Code	278
Min. Negotiated Rate	$113.15
Max. Negotiated Rate	$2,347.50
Rate for Payer: Aetna Commercial	$1,784.10
Rate for Payer: Aetna Medicare Advantage	$1,408.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$1,197.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$1,197.22
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$939.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$1,197.22
Rate for Payer: Cigna Commercial	$2,347.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,136.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,032.90
Rate for Payer: Qualcare PPO/HMO/WC	$704.25
Rate for Payer: UnitedHealthcare Community & State	$113.15
Rate for Payer: Wellpoint Medicaid Managed Care	$124.42

PIN 14MM CASPAR DISTRACTOR

Facility

$4,695.00

Service Code	HCPCS C1713
Hospital Charge Code	270657251
Hospital Revenue Code	278
Min. Negotiated Rate	$704.25
Max. Negotiated Rate	$1,136.19
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$939.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$1,136.19
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$1,032.90
Rate for Payer: Qualcare PPO/HMO/WC	$704.25

PIN 2.4MM

Facility

$1,485.00

Hospital Charge Code	270684912
Hospital Revenue Code	272
Min. Negotiated Rate	$222.75
Max. Negotiated Rate	$222.75
Rate for Payer: Qualcare PPO/HMO/WC	$222.75

PIN 2.4MM

Facility

$1,485.00

Hospital Charge Code	270684912
Hospital Revenue Code	272
Min. Negotiated Rate	$35.79
Max. Negotiated Rate	$742.50
Rate for Payer: Aetna Commercial	$564.30
Rate for Payer: Aetna Medicare Advantage	$445.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$378.68
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$378.68
Rate for Payer: Cigna Commercial	$742.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$445.50
Rate for Payer: Oxford Commercial	$297.00
Rate for Payer: Qualcare PPO/HMO/WC	$222.75
Rate for Payer: UnitedHealthcare Commercial	$297.00
Rate for Payer: UnitedHealthcare Community & State	$35.79
Rate for Payer: Wellpoint Medicaid Managed Care	$39.35

PIN 3.0MM THREADED 305MM

Facility

$470.00

Hospital Charge Code	270661012
Hospital Revenue Code	278
Min. Negotiated Rate	$70.50
Max. Negotiated Rate	$113.74
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.40
Rate for Payer: Qualcare PPO/HMO/WC	$70.50

PIN 3.0MM THREADED 305MM

Facility

$470.00

Hospital Charge Code	270661012
Hospital Revenue Code	278
Min. Negotiated Rate	$11.33
Max. Negotiated Rate	$235.00
Rate for Payer: Aetna Commercial	$178.60
Rate for Payer: Aetna Medicare Advantage	$141.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$119.85
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$94.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$119.85
Rate for Payer: Cigna Commercial	$235.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$113.74
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$103.40
Rate for Payer: Qualcare PPO/HMO/WC	$70.50
Rate for Payer: UnitedHealthcare Community & State	$11.33
Rate for Payer: Wellpoint Medicaid Managed Care	$12.46

PIN 40 X 110MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270691972
Hospital Revenue Code	278
Min. Negotiated Rate	$16.29
Max. Negotiated Rate	$338.00
Rate for Payer: Aetna Commercial	$256.88
Rate for Payer: Aetna Medicare Advantage	$202.80
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$172.38
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$172.38
Rate for Payer: Cigna Commercial	$338.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.72
Rate for Payer: Qualcare PPO/HMO/WC	$101.40
Rate for Payer: UnitedHealthcare Community & State	$16.29
Rate for Payer: Wellpoint Medicaid Managed Care	$17.91

PIN 40 X 110MM

Facility

$676.00

Service Code	HCPCS C1713
Hospital Charge Code	270691972
Hospital Revenue Code	278
Min. Negotiated Rate	$101.40
Max. Negotiated Rate	$163.59
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$135.20
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$163.59
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$148.72
Rate for Payer: Qualcare PPO/HMO/WC	$101.40

PIN 5 TRANFIX 300x60 FF1130060

Facility

$669.65

Hospital Charge Code	270632650
Hospital Revenue Code	278
Min. Negotiated Rate	$16.14
Max. Negotiated Rate	$334.82
Rate for Payer: Aetna Commercial	$254.47
Rate for Payer: Aetna Medicare Advantage	$200.90
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$170.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$170.76
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.93
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$170.76
Rate for Payer: Cigna Commercial	$334.82
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.32
Rate for Payer: Qualcare PPO/HMO/WC	$100.45
Rate for Payer: UnitedHealthcare Community & State	$16.14
Rate for Payer: Wellpoint Medicaid Managed Care	$17.75

PIN 5 TRANFIX 300x60 FF1130060

Facility

$669.65

Hospital Charge Code	270632650
Hospital Revenue Code	278
Min. Negotiated Rate	$100.45
Max. Negotiated Rate	$162.06
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$133.93
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$162.06
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$147.32
Rate for Payer: Qualcare PPO/HMO/WC	$100.45

PIN ABSORABLE 40X2MM

Facility

$1,907.50

Hospital Charge Code	270650740
Hospital Revenue Code	278
Min. Negotiated Rate	$45.97
Max. Negotiated Rate	$953.75
Rate for Payer: Aetna Commercial	$724.85
Rate for Payer: Aetna Medicare Advantage	$572.25
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$486.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$486.41
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$486.41
Rate for Payer: Cigna Commercial	$953.75
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$419.65
Rate for Payer: Qualcare PPO/HMO/WC	$286.12
Rate for Payer: UnitedHealthcare Community & State	$45.97
Rate for Payer: Wellpoint Medicaid Managed Care	$50.55

PIN ABSORABLE 40X2MM

Facility

$1,907.50

Hospital Charge Code	270650740
Hospital Revenue Code	278
Min. Negotiated Rate	$286.12
Max. Negotiated Rate	$461.62
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$381.50
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$461.62
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$419.65
Rate for Payer: Qualcare PPO/HMO/WC	$286.12

PIN ABSORABLE ORTHOSORB

Facility

$1,100.00

Hospital Charge Code	270657443
Hospital Revenue Code	278
Min. Negotiated Rate	$165.00
Max. Negotiated Rate	$266.20
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00

PIN ABSORABLE ORTHOSORB

Facility

$1,100.00

Hospital Charge Code	270657443
Hospital Revenue Code	278
Min. Negotiated Rate	$26.51
Max. Negotiated Rate	$550.00
Rate for Payer: Aetna Commercial	$418.00
Rate for Payer: Aetna Medicare Advantage	$330.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$280.50
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$220.00
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$280.50
Rate for Payer: Cigna Commercial	$550.00
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$266.20
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$242.00
Rate for Payer: Qualcare PPO/HMO/WC	$165.00
Rate for Payer: UnitedHealthcare Community & State	$26.51
Rate for Payer: Wellpoint Medicaid Managed Care	$29.15

PIN ACL CROSSPIN 4x50 905853

Facility

$1,939.45

Hospital Charge Code	270633600
Hospital Revenue Code	278
Min. Negotiated Rate	$290.92
Max. Negotiated Rate	$469.35
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$387.89
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$426.68
Rate for Payer: Qualcare PPO/HMO/WC	$290.92

PIN ACL CROSSPIN 4x50 905853

Facility

$1,939.45

Hospital Charge Code	270633600
Hospital Revenue Code	278
Min. Negotiated Rate	$46.74
Max. Negotiated Rate	$969.73
Rate for Payer: Aetna Commercial	$736.99
Rate for Payer: Aetna Medicare Advantage	$581.84
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Indemnity	$494.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) Managed Care	$494.56
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) NJ Health	$387.89
Rate for Payer: Blue Cross Blue Shield of New Jersey (Horizon) PPO	$494.56
Rate for Payer: Cigna Commercial	$969.73
Rate for Payer: MagnaCare PPO/Direct Plus/Exchange/WC	$469.35
Rate for Payer: New Jersey Carpenters Health Fund Self Funded Medical Benefit Plan	$426.68
Rate for Payer: Qualcare PPO/HMO/WC	$290.92
Rate for Payer: UnitedHealthcare Community & State	$46.74
Rate for Payer: Wellpoint Medicaid Managed Care	$51.40

Know your out-of-pocket cost for care.

All Charges